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Which of the following symptoms is NOT associated with DKA?

  1. Abdominal pain.

  2. Confusion.

  3. Decreased thirst.

  4. Polyuria.

The correct answer is: Decreased thirst.

In diabetic ketoacidosis (DKA), symptoms typically reflect severe insulin deficiency and the resultant metabolic changes. Abdominal pain, confusion, and polyuria are all well-known symptoms associated with DKA. Abdominal pain often results from the body's metabolic state; the accumulation of ketones can irritate the gastrointestinal system, leading to discomfort. Confusion can occur due to significant electrolyte imbalances, particularly a drop in sodium levels and the effects of high blood glucose leading to osmotic diuresis, which can impact mental status. Polyuria, or increased urination, is a result of elevated blood glucose levels that exceed the renal threshold, causing glucose to spill into the urine and pull water with it, leading to dehydration. Decreased thirst is not a symptom typically associated with DKA. In fact, thirst usually increases due to dehydration that occurs as a consequence of polyuria. Individuals experiencing DKA often report extreme thirst as their body tries to compensate for the fluid loss. Thus, the symptom that is not characteristic of DKA is decreased thirst, making it the correct choice in this context.